Pediatrics Flashcards by Laura Yockey

What does epiphyseal-metaphyseal “bucket fracture” suggest in infant?

shaking of limbs- abuse in infant

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Diagnosis of shaken baby syndrome

optho exam: retinal hemorrhages

noncontrast CT: subdural hematoma

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What drugs predispose to congenital heart disease (4)

alcohol
lithium
thalidomide
phenytoin

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Maternal illness predisposing to CHD

DM, PKU

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Infection predisposing to CHD

rubella

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Noncyanotic heart defects (3Ds)

VSD, ASD, PDA

shunt L to R

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Cyanotic heart defects (5 Ts)

Truncus arteriosus (One arterial vessel)
Transposition of great vessels (2 arteries switched)
Tricuspid atresia (3)
Tetralogy of Fallot (4)
Total anomolous pulmonary venous return (5 words)

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What CHD presents with cyanosis within first few hours of life

Transposition

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Heart defect associated with Down syndrome

ASD, endocardial defects

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Heart defect associated with Congenital rubella

PDA

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Heart defect associated with Turner syndrome

Coarctation of the aorta

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Heart defect associated with neonatal lupus

congenital heart block

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Heart defect associated with Williams syndrome

supravalvular aortic stenosis

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Heart defect associated with DiGeorge

Tetralogy

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Heart defect associated with maternal lithium use

Ebstein’s anomoly

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Heart defect associated with neonatal thyrotoxicosis

Heart failure

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Heart defects associated with maternal diabetes

asymmetric septal hypertrophy

transposition

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Neonate: Harsh holosystolic murmur at lower left sternal border

VSD

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Neonate: wide and fixed, split S2; systolic ejection murmur LUSB

ASD

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Exam associated with PDA

Continuous “machine-like murmur”, loud S2, wide pulse pressure, bounding peripheral pulses

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Holt-Oram syndrome (3)

absent radii, ASD, first degree heart block

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Given to close/ open PDA

Indomethacin: Closes
PGE1: opens

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Where is the most common location of coartation?

Just below the L subclavian artery

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Associated with “3”s sign on CXR, rib notching

Coartcation

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What is required to survive transposition

septal defect and PDA

CXR shows "egg-shaped silhouette" and increased pulm vascular markings

Transposition

Anomolies with tetralogy (PROVe)

Pulmonary stenosis (most imp indicator) RVH Overriding aorta VSD

What age stranger anxiety develops

6mo

What age pincer grasp develops

12mo

Gross motor milestones: - 2mo - 4-5mo - 6mo - 12mo - 2years - 3years

- 2mo: Lift head/chest - 4-5mo: Rolls front to back - 6mo: Sits unassisted - 12mo: Walks alone - 2years: Walks up/down steps - 3years: Rides tricycle

Language milestones: - 12mo - 15mo - 18mo - 2 year - 3 year

- 12mo: 1 word, 1-step command - 15mo: 5 words - 18mo: 8 words - 2 year: 2-word phrases, 2-step command - 3 year: 3-word phrases

Associated with boot-shaped heart on CXR

Tetralogy

PE findings for tetralogy of fallot

relieved by squatting | systolic ejection murmur LUSB

Avg age of puberty girls, boys | Abnormal ages

Girls: 10.5 years, 8-13 Boys: 11.5 years, 9-14

GI, malignancy, endocrine diseases assoc with Down syndrome

Duodenal atresia Hirschsprung's ALL hypothyroid

What does lymphedema of hands and feet indicate?

Turners

Associated with Large jaw, testes, ears

Fragile X syndrome

What does ABG for CF show?

hypochloremic alkalosis

Most common cause bowel obstruction first 2 years of life

intussusception

Associated with "currant jelly stool"

intussusception

Associated with "sausage-shaped" RUQ abdominal mass

intussusception

Associated with projectile emesis

plyoric stenosis

Drug causing pyloric stenosis

Erythromycin

Diagnosis and treatment of intussusception

air-contrast barium enema

Metabolic derangement associated with pyloric stenosis

hypochloremic hypokalemic metabolic alkalosis

Diagnosis of meckel's diverticulum

Meckel scintography scan (technitium-99m pertechnate)

Presents as suddem, intermittent, painless rectal bleeding in child

Meckel's diverticulum

Types of tissue in Meckel's diverticulum (2)

Pancreatic, gastric

What presents as bilious emesis in first month of life, distension, passage of blood or mucus in stool

Malrotation with volvulus

AXR shows "bird-beak" appearance in children

Malrotation with volvulus

AXR shows pneumatosis intestinalis in infant

Necrotizing enterocolits

When do B-cell deficiencies commonly present?

after 6mo

Bruton's congenital agammaglobulinemia vs transient hypogammaglobulinemia

Both show increased susceptibility to infection at 6 mo (encapsulated organisms) B cells decreased in Bruton's not THI

Dangerous reactions in IgA deficiency

Anaphylactic transfusion reaction, IVIG can lead to anti-IgA antiboidies

Presentation of DiGeorge

Tetany (hypocalcemia) in first days of life

Infections in DiGeorge

viruses, fungi, PCP

Mnemonic for DiGeorge (CATCH 22)

``` Cardiac abnormalities (transposition) Abnormal facies Thymic aplasia Cleft palate Hypocalcemia 22q11 deletion ```

When do T cell deficiencies typically present

1-3 months

Bruton's vs CVID

Similar symptoms, CVID presents later (15-35yrs)

Presents with bleeding, eczema, recurrent otitis media

Wiskott-Aldrich

Caused by a defect in adenosine deaminase

SCID

Ataxia-telangiectasia defect and presentation

Defect: DNA repair Presentation: Cerebellar ataxia, oculocutaneous telangiactasias, malignancies

Malignancies associated with Ataxia-telangiectasia (3)

NHL leukemia gastric carcinoma

Lab findings with Wiskott-Aldrich

Decr IgM, thrombocytopenia

Organisms causing infection in phagocytic deficiences

Catalase + Fungi Gram neg enteric organisms

Prophylaxis for CGD

daily TMP-SMX

Nitroblue tetrazolium is diagnostic

CGD

Presents as omphalitis with delayed separation umbilical cord

Leukocyte adhesion deficiency

Pneumonic for Wiskott-Aldrich (WIPE)

Wiskott-Aldrich Infections Purpura Eczema

Presents as partial oculocutaneous albinism, peripheral neuropathy, neutropenia

Chediak-Higashi

Presents as Course facies, abscesses, hyper IgE, retained primary teeth, eczema

Job's

Job's vs WAS

Both: eczema, infections Job's: eosinophilia, abscesses, course facies WAS: bleeding, encapsulated organisms infection

Deficiency presents with recurrent Neisseria infections

Terminal complement deficiency (C5-C9)

Presentation of C1 esterase deficiency

recurrent episodes of angioedema

Kawasaki vs Scarlet fever

Both: strawberry tongue, rash, desquamation | Scarlet fever: normal lips, no conjunctivitis

(pediatrics) presents with recurrent high fever, hepatosplenomegaly, salmon-colored macular rash

Still's disease (RF-, ANA-)

Polyarthritis vs pauciarticular arthritis

Polyarthritis: >5 joints, symmetric Pauciarticular: <4, uveitis common

3 common causes of otitis media

S. pneumo non-typable h flu Moraxella catarrhalis

(pediatrics) assoc with "steeple sign" on AP film

Croup

What antibiotic causes biliary sludging and kernicterus in newborns

Ceftriaxone

Classic presentation of posttussive emesis and apnea in infant <6mo

pertussis

Treatment of pertussis

erythromycin

Presents as high fever and maculopapular rash after fever breaks

Roseola infantum (HHV-6,7)

rash pattern for measles, rubella, roseola infantum

Measles, rubella: macular papular rash from head to toe | Roseola infantum: spreads from trunk to face and extremeties

Associated with posterior auricular lymphadenopathy

Rubella

Parvovirus B19 presentation

Slapped cheek, arthropathy, aplastic crisis

Of Crigler-Najjar, Dubin-Johnson, Gilbert, Rotor which is unconj, conj?

Unconj: Crigler Najjar, Gilbert Conj: Dubin-Johnson, Rotor

Which type of hyperbilirubinemia is always pathologic in newborn?

Conjugated

CXR in newborn shows ground glass appearance

RDS

What malformation and malignancy associated with Beckwith-Wiedemenn?

Omphalocele | Wilms' tumor

Presents with bilious emesis within hours of first feeding

Duodenal atresia

ACXR: Double bubble sign

duodenal atresia

Most common acute leukemia in children

ALL

Presents with bone pain, fever, anemia, ecchymoses in children

Leukemia

Labs for tumor lysis syndrome

Hyperkalemia, hyperphosphatemia, hyeruricemia

Presents with nontender abdominal mass (may cross midline), horner's

Neuroblastoma

Histology shows round, blue tumor cells with characteristic rosette pattern

Neuroblastoma

WAGR syndrome

Wilms tumor Aniridia Gentourinary abnormalities Mental Retardation

Presents with "onion skin" periosteal reaction

Ewing sarcoma

Location, associated symptoms for Ewings sarcoma vs osteosarcoma

Midshaft vs metaphyses | Ewing associated with systemic sx

Presents with "sunburst" lytic bone lesions

osteosarcoma

What are 3 possible dx with leukocoria in infants

Retinoblastoma Congenital cataracts Retinopaty of prematurity

Presents as irritability, intermittent abd pain, peripheral neuropathy

Lead poisoning

CBC shows microcytic, hypchromic anemia and basophilic stippling

Lead poisoning

Chelation therapies for lead poisoning

EDTA, succimer (DMSA), BAL (IM dmercaprol)

Pediatrics Flashcards

(105 cards)